Provider Demographics
NPI:1710355896
Name:AMBER THRASH CREEL FNP LLC
Entity Type:Organization
Organization Name:AMBER THRASH CREEL FNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:CREEL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:985-839-6945
Mailing Address - Street 1:26308 BUFORD CREEL RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-6322
Mailing Address - Country:US
Mailing Address - Phone:985-839-6945
Mailing Address - Fax:985-839-9379
Practice Address - Street 1:26308 BUFORD CREEL RD
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-6322
Practice Address - Country:US
Practice Address - Phone:985-839-6945
Practice Address - Fax:985-839-9379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty